Fri Nov 10 2023

72 articles - From Friday Nov 03 2023 to Friday Nov 10 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

International Consensus Recommendations for Safe Use of LAMS for On- and Off-label Indications Using a Modified Delphi Process.

Through a modified international Delphi process, we developed general and indication-specific experience- and evidence-based recommendations on the safe use of LAMS.

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Letter to the Editor in Response to ACG Guidelines Update: Diagnosis and Management of Celiac Disease.

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Hepatology

AASLD Practice guidance on Acute-on-chronic liver failure and the management of critically Ill patients with cirrhosis.

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Cystic fibrosis screening, evaluation and management of hepatobiliary disease consensus recommendations.

Through a multidisciplinary committee and public engagement, we have assembled updated recommendations and guidance on screening, monitoring and treatment of CF-associated hepatobiliary involvement and advanced liver disease. While research gaps remain, we anticipate that these recommendations will lead to improvements in CF outcomes through earlier detection and increased evidence-based approaches to monitoring and treatment.

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Meta-analysis

meta-analyses and systematic reviews


Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Clinical trial: predictive factors for response to gut-directed hypnotherapy for refractory irritable bowel syndrome, a post hoc analysis.

These data suggest that patients with a higher burden of gastrointestinal and extraintestinal symptoms are most likely to benefit from gut-specific behavioural intervention for refractory IBS. Clinical assessment of gastrointestinal, somatic and psychological symptom profiles may play a role in selecting patients for gut-directed hypnotherapy.

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Treatment rates and factors associated with direct-acting antiviral therapy for insured patients with hepatitis C-related hepatocellular carcinoma - A real-world nationwide study.

DAA treatment remains underutilised in insured patients with HCV-related HCC; fewer than one in four patients received treatment. Seeing a specialist and having decompensated cirrhosis were predictors for DAA treatment; additional efforts are needed to increase awareness of HCV treatment.

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Am J Gastroenterol

Antibiotics with or without Rifaximin for acute hepatic Encephalopathy in critically ill patients with cirrhosis: A double-blind, randomized controlled (ARiE) trial.

Reversal of overt HE in those on antibiotics was comparable to those on antibiotics+rifaximin.

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Carvedilol plus NUCs for compensated HBV-cirrhosis patients under virological suppression: a randomised, open-label trial.

The overall results did not show statistically significant differences between the added carvedilol strategy and NUCs monotherapy in preventing EVs progression in virologically suppressed HBV-cirrhosis patients. However, the carvedilol-added approach might offer improved outcomes specifically for patients with medium EVs (NCT03736265).

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Outcomes of a Three-Year Quality Improvement Study to Improve Advance Care Planning in Patients with Decompensated Cirrhosis.

ACP initiatives are feasible and may reduce healthcare utilization among decedents requesting less aggressive care.

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Predictors of Respiratory Failure Development in A Multi-Center Cohort of Inpatients with Cirrhosis.

In a multi-center inpatient cirrhosis study of patients not exposed to terlipressin, 15% patients developed RF. RF risk was highest in those admitted with AKI, had GI bleeding on admission and those who developed nosocomial infections, and other organ failures, or received albumin during their hospital course. Careful volume monitoring and preventing nosocomial respiratory infections, renal or circulatory failures could reduce this risk.

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Clin Gastroenterol Hepatol

Buprenorphine versus diclofenac for pain relief in acute pancreatitis: A double-blinded randomized-controlled trial.

Compared to diclofenac, buprenorphine appears to be more effective and equally safe for pain management in AP patients, even in the sub-cohort of moderately severe or severe pancreatitis (Trial Registration

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Effect of real-time computer-aided polyp detection system (ENDO-AID) on adenoma detection in endoscopists-in-training: a randomized trial.

Among endoscopists-in-training, the use of CADe during colonoscopies was associated with increased overall ADR. (ClinicalTrials.gov NCT04838951).

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Metoclopramide Nasal Spray in Women with Symptomatic Diabetic Gastroparesis: A Randomized, Double-blind, Placebo-controlled Phase 3 Study.

Although the primary endpoint was not met using al enrolled patients, treatment with MNS provided significant relief for women with moderate to severe diabetic gastroparesis symptoms. MNS was well tolerated and demonstrated a similar safety profile to placebo. identifier NCT02025725.

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Endosc Int Open

A 3D-printed pedal fixator for connecting different pedal-operated tools reduces the number of mistakes during endoscopic submucosal dissection.

IPEFIX is a simple device to connect different pedals during endoscopic procedures. It helps to reduce the numbers of foot mistakes during ESD and improves operator comfort.

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Bronchoscopy masks mitigate aerosols during upper gastrointestinal endoscopies.

Bronchoscopy masks or similar are a simple, low-cost mitigation technique that can be used during outbreaks of respiratory diseases such as COVID-19 to improve safety and reduce fallow times.

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Costs of purchase, maintenance, microbiological control, and reprocessing of a reusable duodenoscope.

Theoretical costs were higher than observed costs, showing that the theoretical approach is not sufficient. Hypotheses to explain the difference between the two approaches include failing to measure some costs in the survey and challenges in guideline implementation.

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Large serrated polyps indicate a greater risk of advanced metachronous colorectal neoplasia than high-grade adenomas.

The risk for TMAN was higher for patients with SLs = 10 mm than with HGD or SLs < 10 mm. This risk should be considered when planning surveillance intervals for patients diagnosed with large SLs.

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Next-generation sequencing of pancreatic cyst wall specimens obtained using micro-forceps for improving diagnostic accuracy.

NGS data correlate well with histology and may aid in diagnosis and risk stratification of pancreatic cysts. Cyst wall biopsy performs well in diagnosing cysts but was inadequate in five of 24 patients.

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Predicting procedure duration of colorectal endoscopic submucosal dissection at Western endoscopy centers.

We provided two useful tools for predicting colorectal ESD duration at Western centers. Further improvements and validations are encouraged with potential local adaptation to optimize time planning.

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Settings of a novel electrosurgical generator to enable efficient and safe submucosal endoscopic procedures.

ConMed Beamer ESU settings generated from this study were proven safe and effective in a prospective cohort of patients who underwent submucosal endoscopic procedures. This novel ESU can be added to the armamentarium of ESD capable generators.

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Endoscopy

Differences in treatment of stage I colorectal cancers: a population-based study of colorectal cancers detected within and outside of a screening program.

T1 stage I screen-detected CRCs were also more likely to undergo less invasive treatment than non-screen-detected CRCs, adjusted for risk factors such as LVI and tumor differentiation. Future research should investigate whether the choice of local excision was related to unidentified cancer-related factors or the expertise of the endoscopists.

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Linked-Color Imaging versus High-definition White light endoscopy for evaluation of post-polypectomy scars of non-pedunculated lesions. LCI-Scar Study.

s. LCI is highly accurate and has better ability than WLE to rule out recurrence on post-polypectomy scars after resection of large polyps.

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Hepatology

Alternatives to animal testing to assess NASH drugs and hepatotoxicity.

The technological approaches include precision cut liver slices, human liver spheroids, human liver organoids, bioprinted human liver tissues, and microphysiological systems. This review evaluates each of these technologies and their role in providing alternatives to testing in animals.

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Etiology-independent activation of the LTß-LTßR-RELB axis drives aggressiveness and predicts poor prognosis in Hepatocellular carcinoma.

This study demonstrates a prognostically relevant, etiology-independent and cross-species consistent activation of a LTß/LTßR/RELB axis in hepatocarcinogenesis. These observations may harbor broad implications for HCC, including possible clinical exploitation.

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Further decompensation in cirrhosis. Results of a large multicenter cohort study supporting Baveno VII statements.

In cirrhosis, further decompensation occurs in approximately 60% of patients, significantly increases mortality, and should be considered a more advanced stage of decompensated cirrhosis.

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Liver disease in germline mutations of telomere-related genes: Prevalence, clinical, radiological, pathological features, outcome, and risk factors.

TRG mutations significantly increase the risk of developing liver disease. Although symptoms may be mild they may be associated with severe disease. PSVD and cirrhosis were the most frequent lesions suggesting that the mechanism of action is multifactorial.

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Rate and durability of clearance of hepatitis B surface antigen in Alaska Native persons with long-term hepatitis B virus infection: 1982-2019.

Of patients with chronic HBV monoinfection, 0.82% of people per year achieved a functional cure. HBsAg seroclearance was durable for treated and non-treated patients and lasted on average over 13 years without seroreversion. The findings and conclusions in this report are those of the authors and do not necessarily represent the official positions of the Centers for Disease Control and Prevention.

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J Hepatol

Balance of Gata3 and Ramp2 in hepatocytes regulates hepatic vascular reconstitution in postoperative liver regeneration.

The balance of Gata3 and Ramp2 in hepatocytes regulated the proliferation of LSECs and hepatic revascularization via shifting PEDF to VEGFA, which provided potential targets for the prevention and treatment of PHLF. Impact and implications In this study, we revealed a novel mechanism that the balance of Gata3 and Ramp2 in hepatocyte regulated hepatic vascular reconstitution via shifting PEDF to VEGFA during hepatectomy- or ALLPS-induced liver regeneration. We also identified serum PEDF/VEGFA index (SPVI) as a potential predictor for post-hepatectomy liver failure (PHLF) in patients who underwent hepatectomy. This study will provide a better understanding on how hepatocytes contribute to liver regeneration and new targets for the prevention and treatment of PHLF.

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Inhibition of the Renal Apical Sodium Dependent Bile Acid Transporter Prevents Cholemic Nephropathy in Mice with Obstructive Cholestasis.

BA enrichment in proximal TEC followed by oxidative stress and cell death is an early key event in CN. Inhibiting renal ASBT and consequently BA enrichment in TEC prevents CN and systemically decreases BA concentrations. Impact and implications Cholemic nephropathy (CN) is a severe complication of cholestasis with an unmet clinical need for therapy. We demonstrate that CN is triggered by the renal accumulation of bile acids (BA)- that are considerably increased in the systemic blood. Specifically, the proximal tubular epithelial cells (TEC) of the kidney take up BA via the apical sodium-dependent bile acid transporter (ASBT). We developed a therapeutic compound that blocks ASBT in the kidneys, prevents BA overload in TEC, and almost completely abolished al disease hallmarks in a CN mouse model. Renal ASBT inhibition represents a potential therapeutic strategy for CN patients.

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JAK1 promotes HDV replication and is a potential target for antiviral therapy.

Taken together, we uncovered JAK1 as a key host factor for HDV replication and a potential target for new antiviral treatment. Impact and implications Chronic hepatitis D is the most aggressive form of chronic viral hepatitis with no curative treatment. New therapeutic strategies based on host targeting agents are urgently needed. Here, using loss-of-function strategies, we uncover an unexpected interaction between JAK1, a major actor of the innate antiviral response, and HDV infection. We demonstrated that JAK1 kinase activity is crucial for both the phosphorylation of the delta antigen and the replication of the virus. By demonstrating the antiviral potential of several FDA-approved JAK1 inhibitors, our results could pave the way to the development of innovative therapeutic strategies to tackle this global health threat.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Clin Gastroenterol Hepatol

Assessing risk of index serrated polyps.

The most recent US Multi Society Task Force (USMSTF) for Colorectal Cancer (CRC) post-polypectomy guidelines recommend surveillance intervals for sessile serrated lesions (SSLs) based on size, dysplasia, and number of index polyps. 1 Large (>1 cm) hyperplastic polyps (HPs), which previously had a 10 year follow-up recommendation, now have a 3-5 year interval, 2 However, most of the serrated polyp recommendations were based on low quality evidence, underscoring the need for more data.

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The Evolving Landscape of Colorectal Cancer Screening and Colonoscopy Practice: Insights from the Japan Polyp Study.

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Gastroenterology

Toward quantification of H. pylori-associated gastric cancer risk: Further evidence supporting development of population-based strategies for H. pylori eradication.

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Gut

Getting off tract: contributions of intraorgan microbiota to cancer in extraintestinal organs.

These habitats are challenging to sample, and their low microbial biomass among large amounts of host tissue can make study challenging. Nevertheless, recent findings have shown that many extraintestinal organs that are intimately linked to the gut harbour stable microbiomes, which are colonised from the gut in selective manners and have highlighted not just the influence of the bacteriome but that of the mycobiome and virome on oncogenesis and health.

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J Hepatol

Inflammatory bowel disease and primary sclerosing cholangitis: One disease or two?

Implications for the management of the two diseases together are also discussed. Overall, this review summarises the available data in PSC-IBD and discusses whether PSC and IBD are one or two disease(s).

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Calendar of Courses, Symposiums and Conferences.

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Randomized Controlled Trials for Helicobacter pylori Infection: What We Should Compare.

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Response to Andrew et al.

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Response to Fahey et al.

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The Role of Intestinal Ultrasound During Pregnancy in Patients With Inflammatory Bowel Disease.

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Thinking of the Long Puzzling Issue of Several Suboptimal Treatments of Helicobacter pylori Infection.

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Clin Gastroenterol Hepatol

Limited Impact of a Multifaceted Quality Improvement Intervention Upon Adherence to Pancreatitis Quality Metrics.

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Endoscopy

Endoscopic intermuscular dissection of a residual rectal neuroendocrine tumor with high-pressure injection and double-clip traction.

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Endoscopic management of complex colorectal anastomotic leakage with a pelvic collection and rectovaginal fistula.

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Laparoscopy-assisted trans-hiatal endoscopic removal of an intragastric balloon after placement-related esophageal perforation.

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Next generation of virtual chromoendoscopy improves adenoma detection during colonoscopy.

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Positive fecal immunochemical test but negative colonoscopy: what's next?

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Use of simple endoscopic ligation to successfully remove a large torsional colonic lipoma causing intussusception.

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Gastroenterology

An unusual cause of ascites.

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Could gut and food-derived yeast be responsible for activating T-cells in Crohn disease?

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Macroamylasemia or Cholecystitis: What is the Culprit of Abdominal Pain?

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Mirikizumab for the Management of Ulcerative Colitis.

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Now You See Me: Acute and Recurrent Severe Abdominal Pain Associated with Bowel Edema.

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SUNLIGHT'S DARK SIDE: A CASE OF SUBTLE SKIN LESIONS AND HYPERPIGMENTATION.

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Successful HCV viral cure is not the end of the story.

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Gastrointest Endosc

Top Tips for Endoscopic Management of Refractory Barrett's Esophagus.

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Gut

Dietary fibre (and animal products) modulate the association between tryptophan intake, gut microbiota and type 2 diabetes: but how?

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GORD and GLP-1 receptor agonists: an emerging concern for gastroenterologists.

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Rare cause of obstructive jaundice.

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Hepatology

Letter to Editor: Comparing quantitative MRI technologies in steatotic liver disease.

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Letter to the Editor: How to define the futile outcome in patients undergoing surgery for perihilar cholangiocarcinoma?

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Navigating the 'Specific Etiology' steatohepatitis category: Evaluation & management of non-alcohol/non-metabolic dysfunction-associated steatohepatitis.

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Precipitous changes in nomenclature and definitions-NAFLD becomes SLD: Implications for and expectations of AASLD journals.

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Reply: Comparing quantitative MRI technologies in steatotic liver disease.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Letter: "No first among equals"-Authors' reply'.

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Letter: 'No first among equals'.

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Letter: Comparing first-line infliximab and vedolizumab for ulcerative colitis-It depends on how you use the drug. Authors' reply.

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Clin Gastroenterol Hepatol

DEFINING OCCASIONAL CONSTIPATION: A STRAITJACKET?

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Gut

Helicobacter pylori infection alters gut virome by expanding temperate phages linked to increased risk of colorectal cancer.

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J Hepatol

MASLD screening and diagnostic algorithms are interchangeable from existing NAFLD literature.

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Patients with Hepatocellular carcinoma and portal vein tumour thrombosis after successful downstaging may be candidates for liver transplantation:A meta-analysis.

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Population-based screening works: Effect of integrating screening for hepatitis B and C into the general health check-up in Germany.

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